Who We Are:
TwelveStone Health Partners is focused on the medication needs of patients with chronic, complex and rare conditions. For more than 35 years, TwelveStone Health has been dedicated to finding new ways to deliver care designed around the patient. Chronic conditions include Multiple Sclerosis, Cystic Fibrosis, Hemophilia, Crohn’s Disease, Growth Deficiency, HIV, Leukemia, and many others.
For patients, we provide access to the most advanced medications, along with the personal and financial support patients need to live with chronic conditions. For providers, we simplify treatment for complex conditions by eliminating the administrative and clinical burdens placed on your practice when patients need innovative specialty medications.
Providers we serve: Hospitals, Long-Term Care Facilities, Hospice, Home Care, Specialty Clinics Solutions include: MEDIpack packaged medications, nutrition therapy, home infusion services, specialty pharmacy services, and infusion centers.
TwelveStone Health Partners supports the transition from acute to post-acute care environments and the journey from sickness to health. We are currently licensed in 50 states.
This position currently falls under the Centers for Medicare and Medicare Services (CMS) vaccine mandate. If you are selected for this position, you will be required to comply with CMS requirements. A reasonable accommodation process is available for new hires through our Human Resources department.
This position is responsible for working closely with referral sources on initial patient orders to verify insurance coverage, obtain documentation to ensure the product(s) that are being ordered meet(s) insurance requirements, coordinates with authorizations counterparts to insure all info required by insurance to successfully authorize, dispense and bill medications is obtained; process calls for new referrals and patient questions and distribute calls to other departments as necessary.
Essential Duties & Responsibilities

• Manage email, fax and web portals for new referrals and answer incoming calls regarding new referrals and work closely with other departments to complete referrals. Verify insurance coverage online or via phone to determine patient OOP, obtain documentation to ensure the product(s) that are being ordered meet(s) insurance requirements, coordinates with authorizations counterparts to insure all info required by insurance to successfully authorize, dispense and bill medications is obtained. Capture all relevant information in internal systems.
• Arrange nursing as needed for patients with a variety of nursing agencies, based on insurance and patient need and assist in negotiating nursing rates with nursing agencies if subcontracting is needed due to insurance company requirements.
• Coordinate with Clinical Liaisons to schedule learning events at facilities as needed.
• Other duties as assigned.

Minimum Qualifications:
Education: High School Diploma or GED required. Current, unrestricted Pharmacy Technician license in the state of practice and Pharmacy Technician certification preferred.
Experience: One to two years of related intake or medical office experience required. IV/Specialty Pharmacy Experience (preferred). Knowledge of HCPC coding, medical/pharmacy terminology and ICD-10 codes preferred. Medical ERM and/or other medical software knowledge required.
Functional Competencies:Attention to detail, critical thinking, problem solving, approachable, phone etiquette, dependable, verbal and written communication, teamwork, cooperation, collaboration.

Job Type: Full-time

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